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Aldammas F, Alshihri AA, Alhowaish RK, Alotaibi BM, Alhamdi AF, Algharbi FF, Alhassoun HY, Alhamad MH, Alhaddab AA. Awareness, preconception, and fear of epidural analgesia among childbearing women in Saudi Arabia: An observational cross-sectional study. Saudi J Anaesth 2023; 17:45-57. [PMID: 37032678 PMCID: PMC10077783 DOI: 10.4103/sja.sja_782_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Labor pain is one of the most excruciatingly painful sensations a woman can have. A woman's attitude toward childbirth might be influenced by her lack of understanding of the birth process and the pain she experiences throughout labor and delivery. The control of pain is an important aspect of appropriate obstetrical care. Our study aims to measure the level of awareness, preconception, and fear of epidural analgesia (EDA) among childbearing women. Methods An observational cross-sectional, hospital-based study was conducted using a self-administered questionnaire. The study included all pregnant women who were attending an obstetrical clinic for routine antenatal follow-up at King Khalid university hospital in Riyadh, Saudi Arabia, during the month of August 2022. They were asked about five main parts that tapped their awareness, preconception, and fear of EDA. Data were analyzed by SPSS version 26 using descriptive methods, including mean, frequency, and percentage, and also Pearson's correlation coefficient for regression analysis to find the correlation between socio-demographics and awareness and between awareness and fear. Results Participants in our study included 202 childbearing women. Most women, about 113 (55.9%), participating in the study were aged between 25 and 34 years old. The majority of the participants of this study were Saudi, about 196 (97.0%). In terms of education, 120 (59.4%) of the participants graduated from university. One hundred and forty two (70.3%) of the participants had a monthly income of less than 10000. When it comes to parity, the majority of participants, about 102 (50.5%), have had more than two pregnancies. The average percentage of awareness among the participants showed 45.9%, with an insignificant very moderate correlation between parity and awareness (r = -0.088, P = 0.107); women's knowledge, income, and age were also insignificantly related to awareness. Also, the result showed a moderate level of fear with an average percentage of 44.6% among the participants, with a moderate correlation between awareness and fear with a value of (r = 0.184, P = 0.004). Conclusion This study results demonstrate a good level of desirability toward using EDA for labor pain, yet there is a limited level of preconceptions and a low level of awareness and knowledge about EDA. In addition, the results showed that the average percentage of fear is 44.6%. Therefore, we suggest that more awareness, knowledge, and guidance about EDA should be provided to pregnant women through antenatal clinics. Furthermore, educational campaigns should be made to dispel misconceptions and fears about EDA.
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Affiliation(s)
- Fatma Aldammas
- Department of Anesthesia, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Abdulrhman A. Alshihri
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Rayan K. Alhowaish
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Basheer M. Alotaibi
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Abdullah F. Alhamdi
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Faisal F. Algharbi
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Hamad Y. Alhassoun
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Mohammed H. Alhamad
- Department of Intern, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Abdullah A. Alhaddab
- Department of Student, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
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Mazda Y, Uokawa R, Tanabe S, Ootaki C. Current situation of labor epidural analgesia in Japan: a cross-sectional study. Int J Obstet Anesth 2020; 44:56-57. [PMID: 32799067 DOI: 10.1016/j.ijoa.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Y Mazda
- Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
| | - R Uokawa
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Anesthesia, Chibune Hospital, Osaka, Japan
| | - S Tanabe
- Department of Anesthesiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - C Ootaki
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Ali Alahmari SS, ALmetrek M, Alzillaee AY, Hassan WJ, Ali Alamry SM. Knowledge, attitude, and practice of childbearing women toward epidural anesthesia during normal vaginal delivery in Alsanayeah Primary Health Care in Khamis Mushait. J Family Med Prim Care 2020; 9:99-104. [PMID: 32110573 PMCID: PMC7014839 DOI: 10.4103/jfmpc.jfmpc_530_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/22/2019] [Accepted: 12/04/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Labor pain is a severe form of agony that females experience while giving birth. A lot of pregnant women prefer epidural anesthesia (EA) to avoid labor pain. OBJECTIVE This study focuses on women's general awareness about EA during the childbearing age. METHODS A cross-sectional, hospital-based study was conducted using a self-administered questionnaire. The study included all females of childbearing age getting routine antenatal care. The survey was designed to measure their awareness toward EA. A total of 328 females participated in the study. Of these, 205 (62.5%) women showed a low level of knowledge toward EA. Data were analyzed using the Chi-square test and Independent Samples t-test. RESULTS Participants in our study included 328 women of childbearing age. Most women (172 [52.4%]) participating in the study were aged between 30 and 40 years. In terms of education, 204 (62.2%) women had university-level education. Two hundred and ninety (88.4%) women were multipara. The majority of women (205 [62.5%]) had a low-level knowledge about EA with a significant relationship between the level of perception and primary education, as well as postgraduation with P < 0.023 and P < 0.001, respectively. Also, previous EA with pregnancy significantly related to the level of knowledge with P < 0.001. Through past pregnancies, 106 (32.3%) women had experience with EA. Of these, EA caused complications in only 13 (12.3%) women and side effects in 29 (27.4%) women. CONCLUSION The majority of women of childbearing age had limited knowledge about the benefits and complications associated with EA. During the antenatal visit, it is essential to educate all women about EA. This could be done by the obstetrician, anesthesiologist, or midwives and/or through flyers and brochures.
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Affiliation(s)
| | - Meterk ALmetrek
- Department of Clinical Health Education, General Directorate of Health Affairs in Aseer Region, Saudi Arabia
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Chen R, Cheng Y, Li J. Pregnant women’s awareness and acceptance of epidural anesthesia and its influence on cesarean section rate control in China: A qualitative study. Health (London) 2013. [DOI: 10.4236/health.2013.59198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Okojie P, Cook P. Immediate and delayed complications of epidural analgesia in labour and delivery. J OBSTET GYNAECOL 2009; 19:370-2. [PMID: 15512333 DOI: 10.1080/01443619964661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A prospective controlled, longitudinal study investigated the immediate and delayed complications of epidural analgesia in labour. One hundred and twenty-two parturients were studied: 81 had epidurals in labour and 41 had other forms of analgesia. Each parturient was studied over a period of 6 weeks. Epidural analgesia in labour and delivery is generally safe. Although the epidural group recorded more complications, they tended to be minor ones such as backache, headaches, shoulder and neck pain. Epidural blocks have an added advantage of being helpful in complicated labours like breech presentations, multiple pregnancies, pre-eclampsia, in situations where caesarean section is anticipated and in manual removal of the placenta.
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Affiliation(s)
- P Okojie
- Department of Obstetrics and Gynaecology, Wexham Park Hospital, Slough, UK
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Balcioglu O, Akin S, Demir S, Aribogan A. Patient-controlled intravenous analgesia with remifentanil in nulliparous subjects in labor. Expert Opin Pharmacother 2007; 8:3089-96. [DOI: 10.1517/14656566.8.18.3089] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Edelstein S, Edoute Y. Bacterial sacroiliitis probably induced by lumbar epidural analgesia. Infect Dis Obstet Gynecol 2004; 11:105-8. [PMID: 14627216 PMCID: PMC1852277 DOI: 10.1080/10647440300025506] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Properly administered, lumbar epidural analgesia provides adequate pain relief during labor and
delivery, and is considered to be a safe procedure with limited complications. The prevalence of infection after
lumbar epidural analgesia is negligible. Introduction: Infection of the sacroiliac joint, although very close to the pucture area, has never been reported as
a procedure complication. Case: In this report, we describe a patient who experienced bacterial sacroiliitis a few days after lumbar epidural
analgesia for labor. No portal of entry was identified, and we evoked a new potential risk factor that has never
been proposed before, namely lumbar epidural analgesia. Conclusion: Sacroiliitis must be considered as a rare but serious complication of lumbar epidural analgesia.
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Affiliation(s)
- Shimon Edelstein
- Department of Internal Medicine C, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Lurie S, Rigini N, Zabeeda D, Sadan O, Ezri T, Glezerman M. Changes in platelet function, volume and count during labor and 24 hours postpartum. Platelets 2003; 14:355-8. [PMID: 14602549 DOI: 10.1080/09537100310001598828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Increased platelet activation has been reported during labor. We evaluated changes in platelet count, volume and function during labor and 24 hours postpartum. Platelet function during labor was not previously evaluated. Twenty-five healthy women in labor, subsequently having singleton spontaneous vaginal delivery following uncomplicated pregnancy at term were recruited for this prospective study. Blood was withdrawn during latent phase, active phase, second stage of labor, and 24 hours postpartum. Platelet function was assessed by hemoSTATUS2 test (Hepcon, Medtronic, USA). Twenty-five healthy non-pregnant volunteers served as controls. Platelet count and volume did not change significantly throughout labor and 24 hours postpartum. Platelet function was 120.8 +/- 26.9 %, 106.8 +/- 24.6 % (p = 0.06), 105.2 +/- 30.9 % (p < 0.05), and 117.6 +/- 21.5 % during latent phase, active phase, second stage of labor, and 24 hours postpartum, respectively. Platelet function was altered during labor while platelet count and volume did not change significantly. Platelet function remained increased when compared to non-pregnant controls.
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Affiliation(s)
- Samuel Lurie
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel.
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Lurie S, Feinstein M, Heifetz C, Mamet Y. Epidural analgesia for labor pain is not associated with a decreased frequency of uterine activity. Int J Gynaecol Obstet 1999; 65:125-7. [PMID: 10405055 DOI: 10.1016/s0020-7292(99)00005-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE To evaluate the effect of epidural and pethidine analgesia on the frequency of uterine contractions during the first stage of labor. DESIGN Retrospective study. SETTING Delivery ward of a public hospital. PATIENTS Forty consecutive parturients. MEASUREMENTS AND MAIN RESULTS The mean number of contractions in the 30 min before administration of pethidine analgesia was 8.2+/-1.7 as compared to 8.7+/-1.3 after administration of the analgesia. The mean number of contractions in the 30 min before administration of epidural analgesia was 8.0+/-1.4 as compared to 8.8+/-1.9 after administration of the analgesia. The differences between the two groups and between the number of contractions before and after the administration of both types of analgesia were not statistically significant. CONCLUSION Properly and timely administered epidural analgesia during the first stage of labor has no effect on frequency of uterine activity.
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Affiliation(s)
- S Lurie
- Department of Obstetrics and Gynecology, Laniado Hospital, Netanya, Israel
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Lurie S, Priscu V, Hagay ZJ. Pulse oxygen saturation in parturients receiving epidural versus opioid analgesia for labor. J Clin Anesth 1997; 9:87. [PMID: 9051553 DOI: 10.1016/s0952-8180(96)00182-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Donner B, Tryba M, Strumpf M, Dertwinkel R. [Dangers and complications in pain therapy with epidural and intrathecal catheters.]. Schmerz 1995; 9:219-34. [PMID: 18415528 DOI: 10.1007/bf02529443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/1994] [Accepted: 05/15/1995] [Indexed: 11/26/2022]
Abstract
Pain therapy with epidural or intrathecal catheters is an invasive method. These techniques have specific indications in both acute and chronic pain therapy. However, complications can occur. Thus, the potential complications and the therapy necessary must be known.Drugs: Complications resulting from acute local anesthetic intoxication's are rare. High plasma levels during chronic therapy may lead to confusion. Respiratory depression can occur in opioid naive patients up to 12 (-24) h after injection. Adequate monitoring is a prerequisite for this therapy. After application of clonidine, hypotension is frequent in hypertonic and hypovolemic patients. Epidural or intrathecalcatheter placement can result in therapeutic failure, trauma by punction and inability to place the catheter. During chronic therapy, technical problems can occur, e.g., dislocation, occlusion. To exclude intrathecal and intravascular placement, application of a test dosage of a local anesthetic with adrenaline is recommended.Neurological complications can result in nerve root deficit or "simple" post-spinal headache, but cauda equina syndromes, paralyses, intracranial bleeding, sinus thrombosis and central neurological deficits have been reported. Skininfection at the insertion site of the catheter has been observed with an incidence of 1.9 to 7.7%. A spinal infection with neurological deficit is rare. Spinal infections are often associated with other diseases. Spinalhematomas are rare. Coagulation disorders and anticoagulants can lead to bleeding. Intravenous heparin should be avoided, because this is frequently associated with spinal bleeding. Therapy with cumarines is a contraindication for insertion of spinal catheters.Monitoring: During treatment with spinal catheters, adequate monitoring increases safety for the patients. Efficacy of the injections, puncture site and the neurological status should be documented daily. Neurological deficits must be diagnosed without losing time and adequate therapy must be initiated.
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Affiliation(s)
- B Donner
- Klinik für Anaesthesiologie, Intensiv- und Schmerztherapie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Universitätsklinik, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum
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